YES eCampus | student application form

Application Guideline

All sections must be completed.
Copies of documents and photographs submitted will be filed for our record purposes and will not be returned, even if the applicant decides not to continue with his/her application after submission. All information and documents will be kept in confidence and in accordance with the Personal Data Protection Act 2010. Failure to comply with these procedures may result in a delay in processing this application.

Select Program

Program Level*

Subjects

Maths (Matematik)
Science (Sains)
History (Sejarah)
Principles of Accounting (Prinsip Perakaunan)
Biology (Biologi)
Physics (Fizik)
Chemistry (Kimia)
Add. Maths (Matematik Tambahan)

Subjects

Malay (Bahasa Melayu)
English (Bahasa Inggeris)
Maths (Matematik)
Science (Sains)
History (Sejarah)

Subjects

Malay (Bahasa Melayu)
English (Bahasa Inggeris)
Maths (Matematik)
Science (Sains)

Intake*

HOW DO YOU KNOW US

Source(s)*

Name of Agent

Devan
Edward Chan
Ken
Dr Lai
Michael Leong
William Yew
Others

Name of Teacher

Details of Applicant

Full Name (as in IC / Passport)*

IC Number*

Date of Birth*

Email Address*

Tel. No. (Mobile)*

Tel. No. (House)

Race*

Gender*

Male
Female

Upload Your Photo*

In colour and identical, not black and white. Taken against a WHITE background. Size: 35 mm by 50 mm and not more than 1MB

Upload Your MyKad

Upload your clear iKad photo, Size: Not more than 1MB

Correspondence Address*

Street Address Address Line 2 City State Zip code Country

DETAILS OF PARENTS, GUARDIAN OR NEXT OF KIN

Relationship

Name

Tel No (House)

Tel No (Mobile)

Tel No (Office)

Email Address

Correspondence Address

Street Address Address Line 2 City State Zip code Country

DETAILS OF SCHOOL

School Name*

City / Town

State

Country

DECLARATION

I certify that the information given herein is true and correct, and I acknowledge that any false and/or incorrect information or documentary evidence may result in the cancellation of my enrolment in the program of study.
I understand that the offer letter issued to me will become void if I fail to submit all the relevant documents and pay the required course fees by the due date.
I agree to inform the Registrar in writing of any change in the information given herein, and I understand that YES eCampus will not be held liable as a result of my failure to do so.
I understand and agree that YES eCampus shall forfeit the security deposit paid by me if I remain inactive for one year without notifying the Registrar in writing.
I understand and agree that any fees, deposits and/or monies due to me that remain unclaimed for a period of one year or more from the date of my becoming inactive in my program of study, will be transferred to any nominated education or charitable fund without further reference to me.
I hereby agree and authorise YES eCampus to release my personal information given herein to any authorised agencies and/or bodies of YES eCampus or its business partners for the purpose of enrolment, educational evaluation, transfer of courses and any other administrative process; and to any relevant government bodies/agencies for enforcement of the law.
I authorise and grant YES eCampus the right to use my personal information such as name, credentials, academic record, image, and spoken and written records of my activities at YES eCampus, in posters, leaflets, brochures, advertisements, websites, films, electronic recordings and the like for the marketing and promotion of YES eCampus's corporate image and programs of study, and/or any purposes incidental to it.
I understand and agree that YES eCampus and its authorised representatives shall have unlimited use of, and exclusive rights, titles and interests including copyrights over, the materials mentioned in clause above herein, during and after my graduation from YES eCampus.
I understand and agree that YES eCampus shall release my examination results and my academic record to my parents and/or sponsor(s) as and when it is deemed necessary.
I understand and agree that if I revoke my consent to any of the terms specified in clauses above herein, I must do so in writing to the Registrar of YES eCampus and that all actions taken by YES eCampus prior to the revocation in exercise of their rights in respect of me will not be affected.
I understand and agree to comply with all policies, rules and regulations of YES eCampus, including the rules and regulations of the respective departments, during my program of study at YES eCampus.

Terms & condition*

I hereby declare that I have read and understood all the terms specified and agree to abide by them.

Date

Comments

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